AB0568 CLINICAL USE OF ACTIVATED LEUKOCYTE CELL ADHESION MOLECULE, HEMOPEXIN, AND PEROXIREDOXIN 6: A POTENTIAL URINE BIOMARKER FOR KOREAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: J. W. Kim, J. Y. Jung, H. A. Kim, C. H. Suh
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is sometimes difficult to make a prompt and accurate diagnosis due to the heterogeneity of various clinical manifestations and autoantibody expression. Therefore, the development of surrogate markers specific to the diagnosis of SLE is necessary. Among biological samples, urine is non-invasive means with the advantage of being easily obtained. <h3>Objectives</h3> This study aimed to evaluate the ability of Activated Leukocyte Cell Adhesion Molecule (ALCAM), Hemopexin, and Peroxiredoxin (PRDX) 6 as urine biomarkers in Korean patients with SLE. <h3>Methods</h3> Urine samples were collected from 138 patients with SLE and 39 healthy controls (HC) with clinical data. The level of urine biomarkers were measured by enzyme-linked immunosorbent assay kits specific for ALCAM, hemopexin and PRDX 6, respectively, according to the manufacturer's protocols. The diagnostic utility of urine biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis, and Pearson's correlation analysis was performed to assess the relationships between disease activity and urine biomarkers. <h3>Results</h3> Urinary ALCAM level was 6,760.5 ± 2,826.4 pg/ml and 1,192.6 ± 577 pg/ml in patients with SLE and HCs (p &lt; 0.001). The mean levels in urinary hemopexin and PRDX6 were also significantly higher in patients with SLE compared to HCs (hemopexin, 649.8 ng/ml vs. 202 ng/ml, p &lt; 0.001; PRDX6, 0.78 ng/ml vs. 0.17 ng/ml, p = 0.003). In patients with lupus nephritis (LN), ALCAM, hemopexin, and PRDX6 showed more significant diagnostic value, and the area under the ROC for LN was 0.850 for ALCAM (95% CI, 0.778–0.921), 0.781 for hemopexin (95% CI, 0.695–0.867), and 0.714 for salivary S100A8 (95% CI, 0.617–0.812). In addition, all urine biomarkers were significantly associated with anti-double stranded DNA (ALCAM, r = 0.350, p &lt; 0.001; hemopexin, r = 0.346, p &lt; 0.001; PRDX6, r = 0.191, p = 0.026) and SLEDAI (ALCAM, r = 0.526, p &lt; 0.001; hemopexin, r = 0.479, p &lt; 0.001; PRDX6, r = 0.262, p = 0.002) in correlation analysis. <h3>Conclusion</h3> Urinary ALCAM, hemopexin and PRDX 6 were significantly increased in patients with SLE compared to HCs. Thus, we propose that urinary ALCAM, hemopexin and PRDX 6 can be potential biomarkers for SLE, especially valuable in the diagnosis of LN. <h3>References</h3> [1]Ding H, Lin C, Cai J, Guo Q, Dai M, Mohan C et al., Urinary activated leukocyte cell adhesion molecule as a novel biomarker of lupus nephritis histology. <i>Arthritis Res Ther</i> (2020) 22(1):122. Doi: 10.1186/s13075-020-02209-9. [2]Soliman SA, Haque A, Vanarsa K, Zhang T, Ismail F, Lee KH et al., Urine ALCAM, PF4 and VCAM-1 surpass conventional metrics in identifying nephritis disease activity in childhood-onset systemic lupus erythematosus. <i>Front Immunol</i> (2022) 26;13:885307. Doi: 10.3389/fimmu.2022.885307. [3]Krata N, Foroncewicz B, Zagozdzon R, Moszczuk B, Zielenkiewicz M, Paczek L et al. Peroxiredoxins as markers of oxidative stress in IgA nephropathy, membranous nephropathy and lupus nephritis. <i>Arch Immunol Ther Exp (Warsz</i>) (2021) 70(1):3. Doi: 10.1007/s00005-021-00638-1. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.